HomeMy WebLinkAboutB00-046-171 -4- .->. Development Services Department
240 West Huntington Drive,Post Office Box 60021 PERMIT NO. BOO-046-171
-,:..,,,',ii' Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Tenant Improve w/energ;
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
3/24/2014 CM 1 1:48 3/24/2014 Plan check
ADDRESS NO Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-387
OWNER MAILING ADDRESS I
Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. I Plan Chk#: 14-147
Los Angeles, CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
PHONE NO. (702)461-3798
Cortlnd Morgan(Brian)
EMAIL ADDRESS:
'
CONTRACTORIPROFESSIONAL MAILING ADDRESS
PHONE NO. FAX NO.
EMAIL ADDRESS:
License No. Type: Expires.
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
Fuwa Raman House
'
DESCRIPTION ! 1
TENANT IMPROVEMENT
ti r
Construction Type UOM #of Units Value Construe n ype IOM it of Units Value
Value Value 90,000 00 $90,000.00
OCCUPANCY: Tenant Improve TOTAL VALUATION: $90,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 741.33 741 33 01-3103
each Energy p/c fee 250 91 250.91 01-3103
PC ADA 111.20 111.2001-3103
PC Cal Green 74.13 74:13 01-3103
1.00 Flat Bldg Issue Auto 44.35 01-3104
each Bldg permit 1,140.50 01-3104
Bldg Issue ADA 114.05 01-3104
1.00 each T.I.Fire Pkc 235.00 235.00 01-3109
SMIP Corn 18.90 14-2207
grn bldg std 4.00 714-2203
I.00 Flat SWMF Auto 6.25 88-3027
Total Fees: $2,740.62 Total Amount Paid: $1,412.57 Paid Today: $1,412.57
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the
Recei pt#: 104302
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from Recei 3 1,177.57
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3109 235.00
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar-
cadia building inspector for a period of 180 consecutive days.
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday
one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m.
by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m.
(Closed on alternate Fridays)
k4octi
. e. PERMIT/PLAN REVIEW APPLICATION Is
,��+1 e. Development Services Department,240 West Huntington Drive,Post Office Bo
%unit''`". Arcadia, CA 91066-6021, (626)574-5416,Fax(626)447-9173 Box 60021
City of
Arcadia
❑LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor performance of the work for which this permit is issued.
OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier
molish,or repair any structure,prior to its issuance,also required the applicant for
such permit to file a signed statement that he or she is licensed pursuant to the pro- Policy Number
visions of the Contractors License Law(Chapter 9(commencing with Section 7000) (This section need not be completed if the permit is for one hundred dollars or less)
of Division 3 of the Business and Professions Code)or that he or she is exempt
there from and the basis for the alleged exemption.Any violation of Section 7031.5 ❑ I certify that in the performance of the work for which this permit is issued,I shall
by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the
workers'compensation provisions of Section 3700 of the Labor Code,I shall
❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered for
sale(Section 7044,Business and Professions Code:The Contractors License Date Signature
Law does not apply to an owner of property who builds or improves thereon,or
who does such work himself or herself or through his or her own
employees,provided that such improvements are not intended or offered for
sale.If,however,the building or improvement is sold within one(1)1 WARNING:Failure to secure Workers'Compensation coverage is unlawful,and
year of shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she did
hundred thousand dollars($100,000),in addition to the cost of compensation,
not build or improve for the purpose of sale).
damages as provided for in Section 3706 of the Labor Code, interest, and
❑I, as owner of the property, am exclusively contracting with licensed attorney's fees.
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property who CONSTRUCTION LENDING AGENCY
builds or improves thereon,and who contracts for such projects with a contrac- I hereby affirm under penalty of perjury that there is a construction lending agency
tor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT:APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RE-
STRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures..
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of
asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for fur-
ther information. G
Name Q. L( c Title PO-c7 JG G1 IAA—J Pj (Z_
PRINT NAME
I certify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner.
I agree to City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadi o enter upo�e above-mention d pro erty or inspection purposes.
Signature 1
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ale° STORAGE REQUIRED: IT TS A MTSDE
KITCHEN SF = 278 1 OPERATION 1
W a V)Ur 11214-6
rclet # / fi dC) 25% of 278 sf = 69.5 If AND VAT ID Ti
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.A PERMIT WIT.
e-tt STORAGE PROVIDED:
IN-HOUSE = 25 If CHECKER AT
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REMOTE = 48 If MUST ALSO 1.]
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TOTAL = 73 lineal feet
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(DATE) 73If >69.5If
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